I have just learned I am pregnant with twins. What do I need to know to breastfeed under these circumstances?

There is a good deal you can do while you are pregnant to make things easier for you later. Before your babies arrive is a good time to learn as much as you can about breastfeeding. There are some very helpful books in the LLLI catalogue for mothers of multiples. Having Twins, by Elizabeth Nobles and Mothering Multiples: Breastfeeding and Caring for Twins or More! by Karen Kerkhoff Gromada are two books that address the special joys and challenges of having (an breastfeeding) more than one baby. You will also find a great deal of information and helpful suggestions in THE WOMANLY ART OF BREASTFEEDING available from the LLLI Online Store.

Mothers of multiples are in special need of support, and one of the best places to find that support is at a La Leche League Group meeting.

It is very important that you pay attention to your nutrition during your pregnancy. Owing to the risk of premature labor in a twin pregnancy, a healthy diet is especially important for a good start. Eating foods with high nutritional value will help you and your babies as they grow in utero, and later as you breastfeed.

Choosing the health care providers you will use during your pregnancy and childbirth will be a very important decision. Pre-natal care is crucial for your babies, and for you. You will want to learn as much as you can about your options during labor and delivery so that you can actively participate in the planning. Many parents prefer to talk with several providers before making a decision. There are several books in the LLLI catalogue that would be helpful in this. You can view our selections on childbirth at the LLLI Online Store

Once you find a doctor for you, the next task is to find a doctor for your babies who is knowledgeable about lactation. Some questions you may want to ask your baby's prospective health care provider are:

How do you feel about breastfeeding in general and about breastfeeding twins?

Do you think it is possible to exclusively breastfeed twins, without using supplements?

If one or both of my babies require special care, can I pump my milk to feed my babies?

Do you encourage mothers and babies to spend time together even while in special care?

A negative response to any of these questions may alert you to a health care provider who may be less than supportive of your decision to breastfeed. Sometimes there will be a neonatologist present for the birth. It may be a good idea to know their procedures and routines ahead of time, as well as meeting him/her.

Take advantage of childbirth classes (if available) as soon as possible just in case you have to be on bed rest toward the end of your pregnancy.

It is crucial for you to line up help at home. Find a person who will support your decisions and not someone who will be critical. Make it clear that you will need help with the housework, not the babies, so that you will be able to devote all your attention to them.

Learn about pumping your milk because you are at higher risk of having to spend a few days separated from your babies than if you were having a singleton birth. A good option is to have a hospital grade double pump available.

When your babies arrive:

It would be ideal for you to begin breastfeeding as soon as possible after the birth. When a mother is expecting more than one baby, sometimes a surgical birth becomes necessary. In this case, some hours may go by before you can start to breastfeed. However, it is important that you nurse your babies as soon as you are able. Some multiple births also take place prematurely. If this happens and you are unable to initiate breastfeeding soon after the birth, you can still pump your breasts to initiate lactation. From the moment of birth, your body will begin the process of producing milk for both your babies and its important to express the milk that is beginning to be produced to establish a good milk supply. For this you can use a high quality breast pump or manual expression.

Milk from mothers of premature babies is quite different from that of mothers of term babies. If your babies are early, they will especially need your milk.

If both babies are born healthy, talk to the pediatrician about breastfeeding them on demand. The ideal setup is rooming in with your babies.

If it should become necessary that the babies receive a supplement, you may want to look into other methods of feeding such as cup feeding, finger feeding, or using a spoon, medicine dropper or syringe. Bottle feeding sometimes can interfere with lactation due to the fact that some babies develop a preference for the artificial nipple, making it harder to reestablish breastfeeding.

Once you and your babies are home, you will need to take care of yourself as well as the babies. Eat healthy food, and enjoy frequent snacks (such as low-fat cheese and crackers, vegetables, yogurt and fruit). This is your chance to be able to eat a lot without gaining weight. Be sure to drink water, juices, or milk to thirst. Try to sleep when the babies are asleep.

Develop a plan for getting the housework and other home management tasks done. Enlist any and all available help, and carefully consider what tasks are most important to you and your family. Assign priorities along with your mate. People's needs come first, especially babies' needs, then comes food and clothing.

Limit your visitors during the first weeks. Family members and friends who come to see the babies can help you in many ways-- they can bring you meals, change diapers, give you a massage, watch the babies while you take a 15 minute walk or a shower, listen to you, etc. Don't be shy about asking for the help you need.

Be aware that many mothers of twins receive criticism from those around them who do not share their enthusiasm for breastfeeding. They may pressure you to use formula or other foods before they are needed or to wean before you feel ready. Sometimes, questions such as "Are you sure you have enough milk?" or "Isn't this too hard for you?" are enough to lower a mother's confidence. Your belief in your ability to produce enough milk for your babies is one of the most important factors in maintaining a great milk supply. Remember always that milk is produced on the principle of supply and demand. The more your babies breastfeed, the more milk your body will produce for them.

Tips for life with breastfeeding twins:

Breastfeed them together to save precious time. This works well during the first weeks. After this you may have to breastfeed them one at a time depending on their particular hunger patterns.

There are several different ways that you can position the babies in order to nurse them at the same time. One way is to place the babies in front of you with their legs overlapping, making an X across your lap. The other position is to place both babies in the clutch hold. You will need pillows at your side (and maybe one on your lap) and you will place the babies on the pillows with their legs going toward the back of the chair. Remember that if you are placing the babies in front of you, you must try to keep their whole bodies turned toward you, their chests against your chest. Their bodies must not be facing up. This is very important to avoid soreness and also to make sure that the babies are receiving enough milk.

Use lots of pillows. There are special pillows available that help in positioning twins, or you can make a nursing pillow yourself.

Alternate feeding each baby from both breasts. This evens out their particular needs and also gives them extra visual exercise.

Learn different positions to breastfeed. Learning to nurse while lying down may be a little tricky to learn the first few weeks, but is worth it for the added rest you will get.

Prepare "changing areas" in several different places in your home.

Don't give babies a daily bath. Just make sure the diaper area and their faces are cleaned every day.

Our FAQs present information from La Leche League International on topics of interest to parents of breastfed children. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature and not intended to be advice, medical or otherwise. If you have a serious breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader. Please consult health care professionals on any medical issue, as La Leche League Leaders are not medical practitioners.

Last updated Tuesday, October 3, 2006 by njb.

Page last edited Sun Oct 14 09:31:04 UTC 2007.